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Palliative social work in rural communities supports seriously ill patients and their families in the places they call home, from remote rural Alaskan fishing villages to small Appalachian mountain towns and countless locations in between. Social work’s person-in-environment perspective provides a useful lens for understanding the biopsychosocial and spiritual realities of living with serious illness and enables an in-depth understanding of how those realities are shaped by rural ways of life. Providing access to high-quality palliative care in rural communities remains a pressing challenge for social workers, as does ensuring that care is responsive to the unique values, preferences, and experiences of rural patients and their families. Social work leadership is needed across the full practice continuum in rural palliative care as social workers harness community strengths to provide patient- and family-centered care.

Rural communities are home to a disproportionate number of older adults, many of whom are living with a serious illness or providing care to a seriously ill family member or friend. For these individuals, hospice and palliative care services can provide much-needed biopsychosocial and spiritual support, leading to an enhanced quality of life. Technologically-mediated interventions hold promise as a strategy to bridge geographic distances between healthcare providers and rural elders; however, the effect of such interventions may be greater when they are designed in a manner congruent with rural culture and compatible with the technological infrastructure common in rural areas. Informed by lessons learned during a pilot study of a telehealth intervention in one Midwestern state (R21CA191165), this presentation includes a discussion of strategies to more effectively recruit, engage, and retain rural older adults into studies testing technologically-mediated interventions for hospice and palliative care patients and their families.

This textbook on palliative social work is a companion volume to the Oxford Textbook of Palliative Medicine and the Oxford Textbook of Palliative Nursing. To that end, this chapter will accomplish the following